Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"Biomechanical effects of powered knee orthoses and articulated ankle-foot orthoses in people with diparetic cerebral palsy: a pilot study.","authors":"Samuel Finnegan, Mikaela Juco, Ranita H K Manocha, Emily Rogers-Bradley","doi":"10.1186/s12984-026-02098-0","DOIUrl":"10.1186/s12984-026-02098-0","url":null,"abstract":"<p><strong>Background: </strong>Diparetic cerebral palsy affects approximately 2 in 1000 people, and can result in gait impairments such as excessive knee flexion and excessive ankle dorsiflexion during the stance phase in gait. Short-term clinical trials using robotic rehabilitation devices have shown gait improvements comparable to invasive multilevel surgery for spastic cerebral palsy. This study aimed to determine if the stiffness of articulated forms of ankle-foot orthoses influences the effectiveness of a powered knee-ankle-foot orthosis on crouch gait reduction. It was hypothesized that AFO stiffness would be an important factor influencing crouch gait in individuals with diparetic cerebral palsy when walking with a powered KAFO.</p><p><strong>Methods: </strong>A pilot study with three participants with diparetic cerebral palsy causing crouch gait was conducted to evaluate the effects of varying ankle stiffness of ankle-foot orthoses on sagittal plane kinematics and kinetics while walking with a powered-knee knee-ankle-foot orthosis. Experimental ankle foot orthoses were made to enable adjustable joint stiffness during the experiment. Optical motion capture and in-ground force plates were used to capture gait biomechanics during self-selected walking for eight experimental conditions.</p><p><strong>Results: </strong>Overall, the presence or absence of a powered knee and AFO stiffness had an impact on ankle and knee biomechanics during walking. Across conditions using the powered KAFO, the greatest improvement in crouch at both the ankle and knee was observed with the highest-stiffness experimental AFO. Ankle torque increased with AFO use, while knee torque increased with the powered KAFO but was lower when paired with the experimental AFOs. Ankle power was not consistently improved by the KAFO and AFO conditions, while knee power generally increased with KAFO use and was highest in the powered conditions.</p><p><strong>Conclusions: </strong>This study provides preliminary results on the impact of ankle-foot orthoses in conjunction with a powered knee exoskeleton, and may inform further exploration of treatment of pathological gaits using robotic assistive devices.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Action observation therapy in pediatric cerebral palsy: an fNIRS-based investigation of cortical responses and balance-a randomized controlled trial.","authors":"Melike Özipek, Mevhibe Saricaoglu, Lütfü Hanoğlu, Fatma Mutluay","doi":"10.1186/s12984-026-02097-1","DOIUrl":"https://doi.org/10.1186/s12984-026-02097-1","url":null,"abstract":"<p><strong>Background: </strong>Cerebral palsy (CP) is a group of permanent neurodevelopmental disorders affecting movement and posture, often accompanied by sensory, perceptual, and cognitive impairments. Action Observation Therapy (AOT), based on mirror neuron activation, has emerged as a promising approach for motor learning and rehabilitation. This study aimed to evaluate the effects of AOT on brain activation and motor-behavioral outcomes in children with CP.</p><p><strong>Methods: </strong>Participants aged 7-15 years who met the inclusion criteria were randomly assigned to either the AOT Group (n = 12) or the Control Group (n = 12). The AOT Group received balance training combined with action observation videos, whereas the Control Group received conventional balance training with non-motor videos and written instructions. Both groups participated in the same exercise program for 30 min per day, five days per week, for three weeks, with progressively increasing difficulty. Pre- and post-treatment assessments included the Pediatric Balance Scale as the primary outcome measure, along with secondary outcomes of functional mobility (Timed Up and Go Test), trunk control (Trunk Impairment Scale), and gross motor function (Gross Motor Function Measure-88 sections D and E). Cortical hemodynamic responses during balance tasks on hard and soft surfaces were assessed using functional Near Infrared Spectroscopy (fNIRS) as the mechanistic outcome measure.</p><p><strong>Results: </strong>Both groups showed significant improvements in balance performance, TUG scores, trunk control, and gross motor function after treatment (p < 0.05), with no significant between-group differences (p > 0.05). Exercise training and ground type significantly influenced cerebral oxygenation, with variations in oxyhemoglobin concentrations across brain regions depending on time, group, and video observation interactions (p < 0.05). Oxyhemoglobin levels decreased in the AOT Group, whereas the Control Group showed increases or surface-dependent fluctuations (p < 0.05).</p><p><strong>Conclusions: </strong>Both AOT and conventional motor learning-based balance training improved balance and motor function in children with CP. However, AOT did not provide additional functional benefits. Exercise training and ground type significantly influenced cerebral oxygenation. Decreased oxyhemoglobin levels in the AOT Group and variable responses in the Control Group suggest modulation of cortical activation by sensorimotor context. Trial registration ClinicalTrials.gov (NCT05995197).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"γ-transcranial alternating current stimulation improves upper-limb motor function in stroke patients and modulates oscillatory imbalance: a pilot randomized controlled trial.","authors":"Chuangjia Wang, Wenfeng Zhang, Lilin Chen, Shuxian Zhang, Li Huang, Jianjing Li, Yinan Ai, Huaiyuan Huang, Jinghui Xu, Haiqing Zheng","doi":"10.1186/s12984-026-02103-6","DOIUrl":"10.1186/s12984-026-02103-6","url":null,"abstract":"<p><strong>Background: </strong>Post-stroke cortical oscillatory activity is frequently disrupted, characterized by increased low-frequency oscillation and reduced high-frequency oscillation, which are associated with stroke severity and motor dysfunction. γ-tACS has the potential to entrain brain oscillations and enhance motor performance in healthy individuals, yet evidence in stroke patients is still limited.</p><p><strong>Methods: </strong>This randomized, double-blind, sham-controlled pilot study enrolled 42 patients with post-stroke upper-limb motor impairment. Participants were randomly assigned to either the γ-tACS group or the sham-tACS group. High-definition tACS was applied over the M1 hotspot (70 Hz, 2 mA peak-to-peak, 20 min/session) for 10 sessions, once daily, in addition to conventional rehabilitation. The primary outcome was the Fugl-Meyer Assessment-Upper Extremity (FMA-UE). Secondary outcomes included the Modified Barthel Index (MBI) and resting-state EEG measures, including spectral power, power-ratio indices, and functional connectivity.</p><p><strong>Results: </strong>A total of 42 participants were included in this trial (γ-tACS, n = 21; sham-tACS, n = 21), and the baseline characteristics were comparable between groups. FMA-UE improved in both groups, but the improvement was greater in γ-tACS group (ΔFMA-UE = 4.64 ± 4.55, P = 0.039, 95%CI=[0.154, 5.799]), whereas between-group differences in MBI improvement were not significant. Baseline EEG showed ipsilesional-contralesional asymmetry, with higher delta power, lower alpha power and elevated delta alpha ratio (DAR), delta beta ratio (DBR), and (delta+theta)/(alpha+beta) ratio (DTABR) on the ipsilesional side. After treatment, γ-tACS reduced ipsilesional delta power and lowered DBR and DTABR. Greater reductions in delta power and DTABR were associated with greater improvement in FMA-UE. In addition, γ-tACS increased ipsilesional beta-band connectivity (FC3-C3 wPLI), and this increase was also associated with motor improvement.</p><p><strong>Conclusions: </strong>Compared with sham-tACS, γ-tACS applied over the ipsilesional M1 improved upper-limb motor function in patients with stroke. These clinical improvements were accompanied by restored oscillatory balance and enhanced network connectivity. Quantitative EEG parameters may serve as useful biomarkers for tracking neurophysiological changes and treatment response during stroke recovery. Trial registration This study was registered in the Chinese Clinical Trial Registry (ChiCTR2300074898, date of registration: 2023/08/18).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trunk and lower limb kinematic alterations during the forward step-down task in women with multiple sclerosis: a comparative 3D motion analysis.","authors":"Hanie Farhangi, Hashem Piri, Rahman Sheikhhoseini, Zahra Ebadi, Mohamadreza Hatefi","doi":"10.1186/s12984-026-02099-z","DOIUrl":"10.1186/s12984-026-02099-z","url":null,"abstract":"<p><strong>Background: </strong>The forward step-down (FSD) task is a fundamental daily movement requiring coordinated trunk and lower limb control. Individuals with Multiple Sclerosis (MS) often experience neuromuscular impairments that may alter movement patterns during such functional tasks. This study aimed to investigate and compare trunk and lower limb kinematics during the FSD task in women with and without MS.</p><p><strong>Methods: </strong>Thirty-six women aged 20 to 40 years participated in the study, including 18 with relapsing-remitting MS (EDSS scores ranging from 1 to 4.5) and 18 healthy controls matched for age, anthropometric measures, and sex. Three-dimensional kinematic data of the trunk and lower limbs were recorded at 120 Hz using a Vicon motion capture system during the FSD task performed from a 16 cm platform. Key events were defined at 60° knee flexion and at maximum knee flexion. Joint angles in the sagittal, frontal, and transverse planes were extracted for the ankle, knee, hip, and trunk. Independent-samples t-tests were used to compare the two groups.</p><p><strong>Results: </strong>Significant kinematic differences were observed between groups. At 60° of knee flexion, the MS group exhibited increased ankle external rotation (P = 0.009) and greater trunk flexion (P = 0.001). At maximum knee flexion, the MS group demonstrated increased ankle external rotation (P = 0.029), reduced knee flexion (P = 0.001), decreased knee internal rotation (P = 0.01), greater hip adduction (P = 0.002), and increased trunk flexion (P = 0.001). These findings indicate altered multi-joint coordination and compensatory strategies in participants with MS.</p><p><strong>Conclusion: </strong>Women with MS exhibit distinct kinematic deviations in the trunk and lower limbs during the FSD task, reflecting neuromuscular deficits and compensatory adaptations. These alterations highlight the importance of targeted rehabilitation strategies that focus on trunk control, hip stabilization, and lower limb strength and dynamic alignment to enhance functional performance and reduce fall risk in this population.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermittent theta burst stimulation modulates mirror visual feedback-induced rhythm suppression for hemiparetic upper extremity recovery after stroke.","authors":"Kenneth N K Fong, Jack Jiaqi Zhang, Georg S Kranz, Ching-Yi Wu, Gary Kui Kai Lau","doi":"10.1186/s12984-026-02088-2","DOIUrl":"https://doi.org/10.1186/s12984-026-02088-2","url":null,"abstract":"<p><strong>Objective: </strong>Theta burst stimulation (TBS) and mirror visual feedback (MVF) reduce interhemispheric asymmetry in both hemispheres, which leads to motor recovery. This study aimed to investigate the modulatory effects of intermittent TBS (iTBS) with MVF in mirror therapy (MT) on hemiparetic upper extremity motor recovery and neurophysiological outcomes in patients with stroke.</p><p><strong>Methods: </strong>We designed a randomized controlled trial with three parallel groups: (1) iTBS with MT; (2) sham iTBS with MT; and (3) iTBS with sham MT. Fifteen out of the included 36 patients with chronic stroke from these three groups respectively in the randomized trial, participated in the EEG evaluation to investigate MVF-induced sensorimotor event-related desynchronization (ERD) during mirror view and direct view conditions pre/post training.</p><p><strong>Results: </strong>Patients who received iTBS with MT or sham MT demonstrated greater improvements in the Fugl-Meyer Assessment Upper Extremity distal sub-scores, in contrast to those who received sham iTBS with MT, whereas iTBS with MT yielded a greater improvement than the sham iTBS with MT among patients with lower upper extremity functioning. The EEG findings showed that iTBS with MT, but not the other two protocols, enhanced the beta ERD over the ipsilesional sensorimotor area.</p><p><strong>Conclusion: </strong>iTBS alone but not about the combination with MT appears to prime the ipsilesional motor cortex to be more receptive to MVF for motor recovery. The neurophysiological mechanisms of different brain stimulation protocols combined with MT with ERD neural substrates for post-stroke recovery can be further studied.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartphone-based real-time feedback to suppress trunk compensation for unsupervised upper limb rehabilitation in patients with brain disorders.","authors":"Su Hyeon Kim, Doo Na Cho, Won Hyuk Chang, Hyo-Chang Seo","doi":"10.1186/s12984-026-02093-5","DOIUrl":"10.1186/s12984-026-02093-5","url":null,"abstract":"<p><strong>Background: </strong>To ensure continuous rehabilitation for patients with hemiparesis due to brain disorders, there is a growing need for simple, accessible systems that enable unsupervised self-training. The occurrence of compensatory trunk movements during the unsupervised exercise may prevent true functional recovery. This study proposes a smartphone-based visual-auditory feedback system designed to detect and suppress compensatory trunk movements in real-time without wearable sensors.</p><p><strong>Methods: </strong>A pilot cohort (n = 16) was first used to calibrate detection thresholds for compensatory trunk movements. Subsequently, a total of 55 hemiparetic patients were enrolled in a randomized controlled trial and allocated to a Feedback (FB) group (n = 27) or a Non-Feedback (NFB) group (n = 28). Participants performed standardised upper limb rehabilitation tasks using the Rapael Smart Board™, a planar upper limb rehabilitation device. The proposed system utilised a smartphone camera with MediaPipe-based pose estimation to track trunk movements and provided real-time traffic-light feedback based on calibrated thresholds. Outcome measures included trunk path length, trunk deviation, task efficiency, and spatial occupancy, which were evaluated using 3D coordinates reconstructed from depth camera data.</p><p><strong>Results: </strong>The FB group demonstrated significantly improved postural stability compared to the NFB group, with a 37.9% reduction in trunk path length (p = 0.014) and a 35.3% decrease in spatial occupancy (p = 0.003). Kinematic analysis revealed that the NFB group's shorter hand path lengths were achieved through kinematic redundancy-specifically, the recruitment of trunk degrees of freedom-rather than through selective upper limb motor control. In contrast, the FB group maintained a stable posture near the neutral position, ensuring true upper limb engagement. The usability assessment demonstrated that the system was well received by users and was reliable (Cronbach's α= 0.775).</p><p><strong>Conclusion: </strong>The proposed system, which integrates mobile technology, effectively suppresses compensatory trunk movements and promotes selective motor control, and ensures that rehabilitation outcomes reflect true upper limb joint engagement rather than kinematic redundancy through compensatory trunk recruitment. While certain design considerations remain, particularly related to dynamic recalibration and the use of a fixed auditory feedback window, the system retains strong potential as an automated feedback solution, offering a scalable and accessible pathway for high-quality unsupervised home rehabilitation.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training-induced cognitive coupling emerges under sham but not active transcranial electrical stimulation in older adults: a triple-blind, randomized, sham-controlled study.","authors":"Yong Jiang, Xue Guo, Isabella Wistuba, Azadeh Lesani, Ivan Chakalov, Perianen Ramasawmy, Andrea Antal","doi":"10.1186/s12984-026-02077-5","DOIUrl":"10.1186/s12984-026-02077-5","url":null,"abstract":"<p><strong>Introduction: </strong>Non-pharmacological methods including training and low-intensity transcranial electrical stimulation (tES) have demonstrated potential in delaying cognitive decline with aging. This study aims to investigate the efficacy of combining repeated tES targeting the left dorsolateral prefrontal cortex with task training on cognitive function in the healthy elderly.</p><p><strong>Methods: </strong>In this triple-blind, randomized, sham-controlled study, fifty-five participants received ten 20-min sessions of concurrent task training and stimulation, including anodal transcranial direct current stimulation (tDCS + T), theta transcranial alternating current stimulation (tACS + T), or sham tES (sham + T). The training consisted of cognitive N-back tasks and dynamic balance exercises delivered across sessions. Attention Network Test (ANT) and the Stroop Color-Word Test (SCWT) were administered before and after the intervention, with a four-week follow-up. Group × Time effects were analyzed using linear or generalized linear mixed-effects models, adjusting for age, sex, and baseline cognitive status.</p><p><strong>Result: </strong>Improved overall reaction time (RT) and executive network efficiency were observed in all groups after intervention in ANT. Participants in the sham + T group showed greater improvements with long-term efficacy across all cue-related conditions, and significantly faster RT than tDCS + T group under the double-cue condition at follow-up was observed (χ² (2) = 6.60, p = 0.03, 95% CI [- 0.11, - 0.02], p = 0.002). All groups demonstrated enhanced SCWT performance post-intervention. A significantly stronger negative correlation between orienting network efficiency score and congruent SCWT performance was observed at the follow-up compared to the baseline in the sham + T group (t = 2.686, p = 0.024). Combining tDCS or tACS with task training did not yield superior benefits over sham stimulation.</p><p><strong>Conclusion: </strong>The observed cognitive improvements likely resulted from training. The absence of add-on effects of tES suggested a potential cancellation between the stimulation-induced modulation and training-driven neural activation induced by task training. Improvements in SCWT performance appear to rely less on orienting or executive engagement after intervention, indicating a shift toward more automatized resource-efficient processing.</p><p><strong>Trial registration: </strong>German Clinical Trials Register, DRKS00031042, Registered June 16, 2023.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal assessment of balance dysfunction in older adults: from classification to clustering-based functional pattern identification.","authors":"Jiayi Sun, Chenhao Li, Mianjia Shan, Yujia Gao, Zilin Wang, Fengxian Wu, Yaming Liu, Wenxin Niu","doi":"10.1186/s12984-026-02095-3","DOIUrl":"10.1186/s12984-026-02095-3","url":null,"abstract":"<p><strong>Background: </strong>Balance dysfunction in older adults is a major risk factor for falls. Conventional subjective scales and single-modality measures may not adequately capture the integrated motor, cortical, and cognitive processes underlying postural control. Using a multimodal feature set, this study aimed to develop an interpretable framework for dysfunction-related classification and for exploring heterogeneity in balance-related functional patterns.</p><p><strong>Methods: </strong>A total of 81 community-dwelling older adults (≥ 60 years old) were recruited and divided into balance dysfunction group (n = 38, BBS ≤ 45) and healthy control group (n = 43, BBS > 45) according to the Berg Balance Scale (BBS). During six stance tasks, center of pressure (COP) trajectories, lower-limb surface electromyography (sEMG), and cortical activation measured by functional near-infrared spectroscopy (fNIRS) were synchronously recorded. Group × task effects were tested using two-way repeated-measures ANOVA. Multimodal features were then used for supervised classification (XGBoost) and for clustering-based exploration of heterogeneity within dysfunction-related multimodal profiles using K-means clustering.</p><p><strong>Results: </strong>Under more challenging postural conditions, the dysfunction group showed larger anteroposterior COP oscillation range, velocity, and area. Muscle activation patterns showed lower rectus femoris contribution together with higher biceps femoris and gastrocnemius activation under selected task conditions, accompanied by altered muscle synergy organization. fNIRS revealed greater activation in premotor cortex, supplementary motor area, and prefrontal cortex regions in the dysfunction group. In classification, XGBoost achieved the best overall performance among the tested models, with 83.56% accuracy. Clustering analysis further identified three functional patterns with graded differences in BBS and Montreal Cognitive Assessment (MoCA) scores, suggesting heterogeneity in dysfunction-related multimodal profiles.</p><p><strong>Conclusion: </strong>Balance dysfunction in older adults is associated with a neuro-muscular-cognitive profile involving impaired postural control, altered lower-limb muscle recruitment, and increased cortical activation under more demanding task conditions. The proposed multimodal framework provides an interpretable approach for classification and for exploring heterogeneity in dysfunction-related functional patterns. Further validation in larger cohorts and simplified sensor configurations will be needed to support broader practical application.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental tasks induce common modulations of oscillations in cortex and spinal cord.","authors":"Patrick Ofner, Dario Farina, Carsten Mehring","doi":"10.1186/s12984-026-02041-3","DOIUrl":"10.1186/s12984-026-02041-3","url":null,"abstract":"<p><strong>Background: </strong>Spike trains from spinal motor neurons contain low-frequency components that modulate muscle force, and higher-frequency components (above 10 Hz) that do not. The functional role of these higher-frequency components in motor control is still debated. We investigated whether mental tasks that modulate the power of cortical oscillations produce corresponding modulations in spinal motor neuron activity above 10 Hz without affecting force output. Such coupling would indicate that some higher-frequency components are not merely arising as a byproduct of force generation nor indirectly contributing to motor control, but simply reflect cortical oscillations propagating to spinal motor neurons. If voluntary power modulations of these higher-frequency oscillations do not affect force output, they could potentially serve as control signals for neural interface applications such as movement augmentation or motor neuroprostheses.</p><p><strong>Methods: </strong>We recruited 15 human participants and recorded high-density electromyography signals (HD-EMG) from the tibialis anterior muscle, as well as electroencephalography (EEG) signals. The cumulative spike train (CST) was computed from the activity of spinal motor neurons decoded from HD-EMG signals. The participants performed sustained dorsiflexion concurrent with foot motor imagery, hand motor imagery, mental arithmetic, or no specific mental task. We analysed the bandpower correlation between EEG and CST signals as well as evaluated the task discriminability of CST bandpower signals with a linear classifier.</p><p><strong>Results: </strong>At the intra-muscular coherence peak, we found statistically significant power correlations between CST and EEG in two separate analyses: first, when correlating across individual trials regardless of the mental task, and second, when correlating across the four mental tasks (Kendall's τ coefficient [Formula: see text], [Formula: see text] respectively; mean ± std. dev.). To evaluate the potential of the CST as a control signal, we classified the mental tasks based on CST bandpower and obtained classification accuracies slightly but significantly above chance level ([Formula: see text]; chance level = 25%).</p><p><strong>Conclusion: </strong>These results show that mental tasks can simultaneously modulate the power of cortical and spinal oscillations. This supports the notion that cortical oscillations not contributing to ongoing force control can propagate to the spinal level. We further demonstrate that mental tasks can be classified from CST bandpower, but classification performance is limited by the low signal-to-noise ratio.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"23 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13355341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology-enabled telerehabilitation for Parkinson's disease: a scoping review of digital rehabilitation systems, delivery architectures, and implementation challenges.","authors":"Chiara Longo, Lorenzo Gios, Susanna Pardini, Raffaello Ferrari, Anita Daves, Giuseppe Jurman, Maria Chiara Malaguti","doi":"10.1186/s12984-026-02059-7","DOIUrl":"10.1186/s12984-026-02059-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Digital technologies are increasingly integrated into neurorehabilitation programs for Parkinson's Disease (PD), enabling remote delivery of therapy, continuous monitoring of motor performance, and adaptive feedback during rehabilitation training. Telerehabilitation systems incorporating wearable sensors, virtual reality platforms, mobile applications, and artificial intelligence (AI) have expanded rapidly in recent years. However, the evidence base remains fragmented across heterogeneous technological configurations, clinical contexts, and delivery models, limiting a comprehensive understanding of how digital rehabilitation systems are implemented in PD care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This scoping review maps the current literature on telerehabilitation for PD with a focus on the technological architectures, care settings, and delivery models used in digital rehabilitation programs. Peer-reviewed studies published between 2020 and 2025 were identified through searches in PubMed with reference to Scopus and Web of Science. Eligible studies investigated remote rehabilitation interventions for PD using digital technologies such as wearable sensors, mobile health applications, virtual reality systems, and AI-supported monitoring tools. Evidence was analyzed across three domains: (i) technological components and digital rehabilitation systems, (ii) rehabilitation setting, and (iii) delivery model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Fifty-three studies met the inclusion criteria. Most interventions were home-based and implemented multi-component digital architectures combining teleconferencing platforms, wearable sensors, and mobile applications. Wearable sensing technologies were used in nearly half of the studies to quantify gait, balance, or tremor, while video platforms and mobile applications supported remote supervision and exercise delivery. Virtual reality systems and serious games were used to enhance engagement and taskspecific training, whereas AI techniques were increasingly integrated to support movement detection, monitoring, and adaptive feedback. Despite generally high usability and acceptability, substantial heterogeneity was observed in outcome measures, terminology, and safety reporting. Few studies explicitly described care pathways, delivery architectures, or long-term clinical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Disscussion: &lt;/strong&gt;Telerehabilitation for Parkinson's disease is evolving toward integrated digital rehabilitation ecosystems combining wearable sensing, software platforms, and AI-enabled monitoring. Although feasibility and patient acceptance are consistently reported, current evidence remains limited by heterogeneous reporting standards and insufficient integration between technological systems and clinical workflows. Future research should focus on standardized outcome frameworks, scalable hybrid care models, and the development of interoperable, explainable digital rehabilitation systems c","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}